States Rush To Figure Out How To Enforce Trump鈥檚 Medicaid Work Requirements
A KFF survey of state Medicaid officials offers insight into lingering uncertainty and differing plans for work requirement implementation as the Jan. 1 deadline approaches.
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A KFF survey of state Medicaid officials offers insight into lingering uncertainty and differing plans for work requirement implementation as the Jan. 1 deadline approaches.
On May 1, the state will become the first to require people on the government health program to fulfill a work requirement or lose their coverage under a new rule that was a key part of congressional Republicans鈥 One Big Beautiful Bill Act.
Moving through the California Senate are two bills, informed by 吃瓜不打烊 reporting, that would strengthen protections for patients brought to health facilities by Immigration and Customs Enforcement.
Montana health officials say they鈥檙e seeking to add doula services to the state鈥檚 Medicaid program, reversing a previous statement that they would 鈥渘ot be moving forward鈥 amid a budget shortfall.
Real estate investment trusts are landlords for thousands of nursing homes, assisted living facilities, and hospitals. Some select the managers and keep close watch over their performance but deny responsibility for bad care.
Physicians, dentists, and other nonhospital providers account for more than 80% of health care debt collection cases in Connecticut courts, a CT Mirror-吃瓜不打烊 investigation finds.
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Starting next year, about 18.5 million adults will be subject to new Medicaid work rules in 42 states and Washington, D.C. Applicants must show they鈥檝e been working for at least a month before receiving benefits. Some Republican-controlled states want to triple the required work period.
A 吃瓜不打烊 analysis found Medi-Cal lost almost 100,000 immigrants without legal status in the second half of 2025. California officials say it鈥檚 not clear if immigrants are losing coverage faster than other populations, but researchers said the most obvious driver is fear of the Trump administration鈥檚 immigration policies.
A rural Nebraska dialysis unit that was hemorrhaging money closed, upending patients鈥 lives. That鈥檚 despite a federal rural health program that granted the state more than $200 million this year to improve health care in rural communities.
As President Donald Trump鈥檚 heightened immigration enforcement continues across the country, some states are updating temporary guardianship laws to keep the children of detained and deported immigrants out of state custody.
Even as the Trump administration publicly embraces the Make America Healthy Again movement and its ideals about reducing corporate harm to the environment, it has taken steps to stall environmental protections that MAHA followers hold dear.
Some states already don鈥檛 have enough staff to quickly process Medicaid applications and answer enrollees鈥 phone calls. Researchers say they may not be prepared to handle new Medicaid work rules, predicting people will lose coverage as a result.
When the only clinic that offered abortions in Michigan鈥檚 rural Upper Peninsula closed, an urgent care facility stepped in to fill the gap. Now, others are considering similar moves as brick-and-mortar clinics close in blue states.
Montana was on track to start reimbursing doulas, who support new and expectant parents, through Medicaid this year. But state officials halted that plan amid a budget shortfall. Other such services deemed optional under Medicaid are at risk nationwide as states brace for federal cuts.
North Carolina rolled out a $3.1 billion insurance plan for kids in foster care, but many doctors did not accept patients on the plan. The state is one of several experimenting with a model that has left kids鈥 guardians scrambling to find health care providers.
After Eric Tennant died, his widow vowed to speak out against West Virginia鈥檚 Public Employees Insurance Agency, which had denied cancer treatment recommended by Tennant鈥檚 doctor. Her efforts paid off. In March, West Virginia鈥檚 governor signed a bill to protect some patients from harm tied to prior authorization.
About 17,000 federally funded health clinics stand to collectively lose $32 billion under GOP-backed fiscal policies in the next five years 鈥 just as more uninsured patients will rely on them for low-cost care.
Federal health officials have ordered states to reverify the immigration status of hundreds of thousands of Medicaid enrollees. After seven months, findings from five states show the reviews have uncovered few immigrants without legal status who are improperly receiving benefits.
The One Big Beautiful Bill Act will add red tape and restrictions for those seeking Medicaid and SNAP benefits. And the costs to update computer systems that determine eligibility for those programs will be steep.
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